ST. JOHN'S WORT

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ST. JOHN'S WORT

St. John's wort may be the most widely used herbal preparation currently on the market. It is an extract prepared from a plant of the same name (Hypericum perforatum) that achieved recognition as an antidepressant following reports from Europe of clinical trials showing that it improved mild depression. Many people take St. John's wort to stave off depression or just to improve their state of mind. Most research shows that St. John's wort may have some effectiveness but not as much as pharmaceutical antidepressants, especially in cases of severe depression.
So why not take a little St. John's wort? By itself it isn't particularly dangerous. However, it has proved to have many negative interactions with other drugs, including some important medications. St. John's wort can stimulate the production of enzymes in the liver that break down other drugs. This allows the liver to break down some drugs so fast that a normal dose doesn't work. Birth control pills are affected in this way, and there are cases in which women taking St. John's wort have become preg­nant because their birth control pills were being degraded too quickly. Even more serious consequences have occurred. There are more than ten case reports of transplant patients who experienced tissue rejection when levels of their immunosuppressant medication fell drastically after they started taking St. John's wort.

Finally, St. John's wort can interact dangerously with one class of antidepressant, the serotonin-specific reuptake inhibitors (SSRIs). Tak­ing both St. John's wort and SSRIs can lead to “serotonin syndrome" because serotonin is inactivated more slowly than usual, resulting in higher-than-normal levels of serotonin in the synapses. At its mildest, people just feel flushed and jittery; at its worst, it leads to an increase in body temperature, heart rate, and blood pressure, and can be fatal.

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